Panchayat:Repo18/Law Manual Page0420
FORM 1
(See Rule 3)
Electoral Roll 20……
………...….. (Constituency No.)/ ……………. (Name of Panchayat) Grama Panchayat Constituency
PART ………………
Name of Polling Station………………………………….. No. of Polling Station …………………………………….. Area of Polling Station ……………………………………
[………………………….. (Constituency No.)/ ………………………. (Name of Panchayat) Grama Panchayat Constituency Electoral roll Part ………….…………]
[………………………….. (Constituency No.)/ ………………………. (Name of Panchayat) Block Panchayat Constituency Electoral roll Part …………....…………]
[………………………….. (Constituency No.)/ ………………………. (Name of Panchayat) District Panchayat Constituency Electoral roll Part ……………………]
Sl. No. |
House No. & House Name (in bracket) |
Name of Elector |
Name of Father/ Mother/ Karanavan/ Husband |
Male/ Female |
Age as on 1st January 1994
|
(1) |
(2) |
(3) |
(4) |
(5) |
(6)
|
Electoral Registration Officer
....................................................